Start 5/1 Flashcards
1
Q
What class are Anti-Rh Abs?
A
IgG
2
Q
Socially inhibited, but desires relationships with others=
A
Avoidant
3
Q
Psychosis that presents with and WITHOUT mood symptoms
A
Schizoaffective
4
Q
What medications are associated with osteoporotic fractures?
A
Proton pump inhibitors (omeprazole; bc dec absorption), anticonvulsants that increase p450 (phenytoin, phenobarbital, carbamazapine), drugs that dec. estrogen (progesterone, and aromatase inhibitors), GnRH antagonists, and glucocorticoids, heparin, thiazolidineiones.
5
Q
Abx for lung abscess / aspiration pneumonia?
A
Clindamycin
6
Q
Hyperacusis is associated with CN:
A
7 (Facial) - the Stapedius muscle is bad
7
Q
Fabry Disease early and LATE manifestations-
A
angiokeratomas, hypohidrosis, acroparethesia
RENAL FAILURE
8
Q
Go to high elevation, what happens to O2?
A
It decreases (~60) until about 10-14 days when Hb increases
9
Q
Warfarin induced necrosis is from
A
Protein C or S deficiency
10
Q
What is the virulence factor of Strep. pyogenes that prevents phagocytosis? What factor lyses erythrocytes?
A
M-protein (prevents phago)
Streptolysin O lyses RBCs
11
Q
What are the functions of beta1 block?
A
Decreased cAMP in the heart and in the KIDNEY JGA APPARATUS!
12
Q
Vasopressin increases absorption of what, where?
A
H20 and UREA at the medullary collecting duct
13
Q
ABs to the alpha chain of collagen type 4 will present with
A
hemoptysis and oliguria (goodpastures)
14
Q
What type of incontinence is seen with MS?
A
Urge- detrusor muscle overactivity from loss of inhibitory innervation
15
Q
17-alpha hydroxylase deficiency in males presents as-
A
External vagina, internal male genitalia, and increased minealcorticoids so hypokalemia.
16
Q
What about thiazide diuretics can cause muscle cramps?
A
Hypokalemia
17
Q
What about mycoplasma treated with erthyromycin can cause anemia?
A
Cold agglutins becuase Mycoplasma is similar to RBCs and when the body attacks it also destroys some RBCs (Nothing to do with tx)
18
Q
Congenital bicuspid aortic valves cause
A
Aortic stenosis in 60s (accelerate the calcific stenosis process of old age)
19
Q
Erosion vs ulcers (layers?)
A
Erosion- mucosa –> muscularis mucosa
Ulcer - mucosa –> muscularis mucosa –> submucosa
20
Q
When is bhcg detectable after fertilization?
A
urine- 14 days
serum- 8 days
21
Q
Terminal bronchiole clears debris by
A
Cilia!!!! (no more goblet cells)
This is the last site of cilia
22
Q
How do you get HAV?
A
Fecal-Oral (like raw oysters)
23
Q
VHL (auto dominant) presents with?
A
Cerebellar hemangioblastoma with congenital cysts (kidney, liver, pancreas)
24
Q
Biggest concern during the recovery phase of ATN is:
A
hypokalemia
25
Thin stratum granulosum with prominent parakeratotic stratum corneum-
Psoriasis
26
What is the cause of fever, muscle rigidity, tachycardia, and hypertension after surgery?
Malignant hyperthermia (abnormal ryanodine receptors cause large intracellular calcium release)
27
How do you treat malignant hyperthermia? (mechanism)
Dantrolene- prevents Ca release from the sarcoplasmic reticulum of skeletal muscle by acting on ryanodine
28
AV shunts ___ preload and ___ afterload.
increase preload and decrease afterload
29
Conduction speed of atrial muscle vs ventricular muscle?
Atrial muscle is FASTER
30
Cirrhosis causes increased estrogen. One manifestation is gynecomastia, what are others?
SPIDER ANGIOMATA, testicular atrophy, and decreased body hair.
31
In primary osteoporosis, PTH is ____ and Ca++ is ___
normal and normal
32
What tumors are s100+ ?
Schwannoma and melanoma
33
Describe the vaccine that should be used to protect older people against pneumococcal pneumonia
Outer polysaccharide covering conjugated to a protein antigen
34
Why do kids get H.flu. ear infections despite vaccination?
The strains responsible do not produce capsules
35
GLUT4 location
skeletal muscle and adipocytes
36
Where do glucocorticoids increase protein synthesis?
Liver (because steroids increase liver gluconeogenesis and therefore catabolize all peripheral tissues to supply the liver with substrates)
37
How does Zidovudine (AZT) work?
Competitively binds RT and is incorporated as a thymidine analog WITHOUT a 3'-OH group, therefore making 3'-5' phosphodiester bind formation impossible.
38
What causes a cauliflower like mass in the intestine and mucous diarrhea?
Villous adenoma
39
Why are reticulocytes blue?
rRNA
40
Saccular vs Charcot-Buchard aneurysm
Saccular - circle of willis; subarachnoid hemorrhage
| C-B- chronic htn and affects small vessels
41
Most common cause of recurrent lobar hemorrhagic stroke in the elderly?
Amyloid angiopathy!
42
What gastroenteritis bacteria can be acquired from pets? (Bonus- what serious complication is this bacteria associated with?)
Campylobacter
| Guillan-Barre and reactive arthritis
43
patients with PCOS are at risk for (2 things)-
type TWO diabetes
| endometrial adenocarcinoma
44
Name two nuclear transcription factors that directly bind DNA? (can be detected with southwestern blot)
c-Jun and c-Fos
45
Aggression, dementia, and choreiform movements are associated with ____? Damage to what structures are characteristic?
Huntingtons
| Caudate nucleus and putamen
46
OAA --> Citrate requires
B5 (CoA addition)
47
How to tx bleeding due to heparin toxicity?
Protamine
48
Anterior pituitary embryologic origin?
Surface ectoderm
49
Prolonged hypotension in the ER that produces RUQ pain is likely-
Acute Acalculous Cholecystitis (seen in severely ill patients)
50
BRAF
malignant melanoma
51
Osteomyelitis in children affects what part of bone?
Metaphysis due to the slow flowing blood
52
Describe the prodrome of HBV.
30-180 days. Serum sickness like (fever malaise rash) followed by spike in ALT and AST
53
Child immigrant with muscle weakness and RNA in CSF has ___? How is it spread??
Polio. Fecal-oral.
54
Describe the body volume status of SIADH
Euvolemic hyponatremia
55
How do you control vomiting caused by GI upset? How does the drug work?
Ondansetron - 5-HT receptor antagonist
56
Why are Abs to HepC ineffective?
Rapid antigenic variation (why making a vaccine is so hard)
57
How do you loosen mucus plugs in CF? How does the drug work specifically.
N-acetylcysteine - disrupts disulfide bonds
58
Receptors:
How to dilate eye?
How to reduce uterine contractions?
eye dilation- alpha-1 agonist
| decreased uterine tone- beta-2 agonist
59
ACTH dependent Cushings- is there fasiculate later hypertrophy or hyperplasia?
HYPERPLASIA
60
How do tumor cell lines become resistant to chemotherapy?
Multidrug resistance protein 1 (MDR1) produces P-glycoprotein, which is an *ATP dependent efflux pump*
61
Histopathology of sickle cell spleen shows:
Fibrosis and atrophy
62
Why would a sickle cell patient have a high MCV?
Folate deficiency (prone due to the hemolytic turnover)
63
How do OCPs work?
Estrogen and progesterone suppress LH and FSH, preventing ovulation.
64
Spleen embryology
Mesodermal dorsal mesentery (although it is supplied by the celiac trunk, which supplies the foregut derived organs)
65
Inhibin decreases ___ and is produced by ____
FSH; Sertoli cells
66
Novobiocin Resistance =
Staph. Saprophyticus
67
Feared Measles complication in older children
SSPE
68
What are the toxicities of macrolides? (azithromycin, clarithromycin, erythromycin)
```
M- GI Motility issues
A- Arrhythmia (long QT)
C-acute Cholestatic hepatitis
R- Rash
O- eOsinophilia
```
69
What viral proteins are glycosylated and then cleaved in the HIV particle?
gp160 --> gp120 & gp 41
70
Inflammation of the antral mucosa with inflammatory infiltrates is ___? What are these patients at risk for?
Type B chronic gastritis (H. Pylori). MALT.
71
How do you differentiate adenocarcinoma from mesothelioma? (histology)
Adenocarcinoma- Short, plump microvilli
| Mesothelioma- Tumor cells with numerous, long slender microvilli and abundant tonofilaments
72
Anterior medial portion of the temporal lobe compressed against the tentorium cerebelli causes ___? (CN?)
Uncal herniation and damage to CNIII
- -> Also damage to ipsilateral PCA (contralateral homon. hemianopsia)
- -> Ipsilateral paresis (false localization sign)
73
Formula for t1/2=
t1/2= 0.7* (Vd/Cl)
74
XY fetus with formal Leydig cells and absent Sertoli cells will have ___.
```
Male external (b/c Leydig make T for viril.)
Male & female internal (b/c Y chrom. makes TDF and absent Sertoli means no MIF)
```
75
How can morphine cause RUQ pain?
Can cause contraction of the smooth muscle cells in the sphincter of Oddi, leading to constriction and spasm.
76
What abx causes myopathy and elevated CPK? How does it work? What can it be used for?
Daptomycin
Lipopeptide that disrupts cell membranes / distort membrane potential
MRSA, bacteremia, VRE, endocarditis
77
What vitamin deficiency has similar neuro symptoms to B12?
E
78
What are risk factors for lung abscesses? (peptostreptococcus, fusobacterium)
Alcoholism, seizure disorders, drug od, severe neuro disease, and prolonged anesthesia.
79
The middle meningeal artery is a branch of what vessel?
Maxillary artery
80
What are the toxicities of MTX?
Hepatotox
Pulmonary fibrosis
Mouth ulcers
Myelosuppression (give Leucovorin)
81
Lesions in 1o vs 3o syphilis are called?
1o- Chancre
| 3o- Gumma
82
What is necrotizing enterocolitis?
Seen in premature formula fed infants.
Bacterial invasion and necrosis of the bowel wall.
See air in the bowel WALL
83
What are longitudinal tears in the esophagus called? What causes them?
Mallory Weiss tear
| Increased abdominal pressure from vomiting
84
Describe positively and negatively skewed distributions. (Mean vs Median vs Mode)
Neg Skew = Mode>Median>Mean
| Pos Skew=Mean>Median>Mode
85
Blisters that spread laterally with pressure are called
Pemphigus Vulgaris (Abs to desmosomes)
86
What causes painful nodule after treated laceration?
Retained sutures forming granulation tissue
87
Key features of Crohn's Disease? Gross & Micro
GROSS- Transmural inflammation-->fistulas. Cobblestone mucosa, creeping fat, bowel wall thickening (“string sign” on barium swallow x-ray A ), linear ulcers, fissures.
MICRO- Noncaseating granulomas and lymphoid aggregates (Th1 mediated)
88
Why is HbS worse than HbC?
Has hydrophobic interaction among Hb molecules
| *** Basically HbS sickles and HcC does not***
89
Describe the Gq pathway. What happens if you block IP3?
binding--> PLC converts Lipids--> PIP2 --> DAG and IP3 --> increase PKC and Ca++
Block IP3--> decrease PKC activity
90
Most likely cause of death in a child with ARF is
Severe myocarditis causing mitral regurgitation
91
How can SAH cause limb numbness? Tx?
Vasospasm (from blood break down)
| Tx- Nimodipine (Ca channel blocker)
92
What are snRNPs?
Formation of spliceosome (remove introns)
| Abs to these are Anti-Smith (SLE)
93
What is tachyphylaxis with regard to decongestants?
The alpha agonists cause reflexive decrease in NEpi. After a few days, this leads to rebound vessel dilation and rapidly declining effectiveness after a few days.
94
In the USA, what is the main cause of liver abscesses?
Bacterial infection
- Ascending cholangitis (E.Coli, Klebsiella, Enterococci)
- Portal vein pyemia
- Hepatic artery seeding (**S. Aureus**)
95
What heart diseases are caused by failure of neural crest migration?
TOF
Transposition
Truncus
96
What are the skin findings in Graves disease?
Skin thickening and induration caused by increased GAG production from fibroblasts
97
What causes jejunal, ileal, and colonic atresia?
Vascular accidents in utero.
| Absent section of duodenum with apple peel ileum
98
Acute stress disorder vs PTSD?
4 weeks
99
What drug is protective against both osteoporosis and breast cancer?
Raloxifene
100
For the love of god, what is the subunit in fetal Hb?
GAMMA
101
What topical treatment is used for psoriasis? Mechanism?
Vitamin D analogs (calcipotriene, calcitriol, tacalcitol).
These ACTIVATE the vitamin D receptor, which is a NUCLEAR receptor.
Causes decreased keratinocyte proliferation and increased differentiation.
102
What is the most specific Ab for RA?
Anti-cyclic citrullinated peptide (CCP)
103
Squamous metaplasia in the pancreatic ducts of CF patients is caused by
Vitamin A deficiency
104
Most common secondary bacterial infections after Influenza viral infection?
Strep pneumo, Staph. A, H. Flu.
105
Isolated systolic htn in the elderly is caused by
Stiffening of aorta
106
Most common vessel for atherosclerotic involvement is
Abdominal aorta
107
Etoposide inhibits
Topoisomerase 2!!!!!!!!!!!!
108
___ is associated with asthma and CF and bronchiectasis and can present with eosinophilia
Aspergillus (Allergic bronchopulmonary aspergilosus)
109
Aschoff bodies
Granuloma with giant cells; int he myocardium of Rheumatic Fever
110
Concern about first dose of ACE i is ___.
First dose htn. Be careful if they are taking diuretics.
111
Chronic NSAIDS cause kidney:
Chronic interstitial nephritis
112
Doxorubicin causes (heart)
dilated CM
113
Cardiac tamponade finding
pulsus paradoxus
114
Jaundice early in life that can present with seizures is caused by
Absent UDP-glucuronosyltransferase (Crigler-Najjar)
115
In alzheimers, the decreased Ach is due to what defective brain region?
Nucleus basalis (of meynert)
116
N-acetyl cysteine is used to treat ____ via ____.
Acetaminophen overdose via sulfhydryl group donation
117
Bug with cat scratch fever? Another major presentation is ___.
Bartonella henselae
| Bacillary Angiomatosis
118
How do you kill HepA?
Boil to 85 for 1 min, bleach, UV, formalin
119
Another name for lactose:
Galactosyl b-1,4-glucose
120
What is nonfunctional in xeroderma pig.?
Endonuclease
121
How do you hear S3 best
Left lateral decub. AT THE END OF EXPIRATION
| Brings the heart closer to the surface
122
What combination of lipid lowering agents is likely to precipitate gallstones?
Bile acid sequestrants (cholestyramine) & Fibrates (gemfibrozil)
123
What vessel is least often involved in PAN?
Pulmonary
124
What is it called when the neuron cell body becomes rounded and the nucleus is displaced to the periphery & Nissl substance becomes dispersed throughout?
Axonal reaction (the Nissl substance is the RER making proteins in response)
125
I say polyarteritis nodosa, you say
HepB
126
Keloid scars are caused by
Excess collagen formation
127
What does mechanical valve hemolysis do to haptoglobin and LDH and serum iron?
decreased haptoglobin
increased LDH
No change in iron
128
What do you ask someone who is abused
Do you have a safe place to go in an emergency?
129
What is the most common cause of viral UTI in kids?
Adenovirus (hemorrhagic cystitis)
130
A hamartoma is a benign coin lesion in the lung. What it is made of?
Islands of mature hyaline cartilage (and fat, smooth muscle and clefts lined by respiratory epithelium)
131
What is the Fick equation for Cardiac Output?
CO= O2 consumption/AV O2 difference
132
Describe the hepatitis that is lethal in pregnant woman.
HEV-
RNA hepevirus, unenveloped, single stranded
fecal-oral
short incubation
133
What is an immediate source for nitrogen in the urea cycle?
Aspartate
134
How does the inactivated influenza vaccine work?
Induce neutralizing Abs against hemagglutinin, preventing viral entry into cells.
135
What part of the intestine is ALWAYS involved in Hirshsprung disease?
Rectum (because the neural crest cells migrate caudally)
136
Histology of acute viral hepatitis
Ballooning degeneration (hepatocyte swelling), mononuclear infiltrates, Councilman bodies (eosinophilic apoptotic bodies
137
How does TNF-a cause insulin resistance?
By increasing serine phosphorylation of the tyrosine kinase insulin receptor and decreasing downstream signalling
138
Sigmoid shaped ventricular septum
normal aging
139
What are the important neutrophil chemotactic agents?
LTB4, 5-HETE, and C5a
140
What vasculitides involve granulomas?
Giant cell, Takayasu
Wegeners, Churg Strauss
141
TCA overdose tx (see long QT, , coma, convulsions [CCC])
NaHCO3
142
Myxomatous changes in arteries
Aortic aneurysm
143
Which diuretic can cause ototoxicity?
Furosemide (and other loop diuretics)
144
Anal fissures are most commonly located
Below the pectinate line and Posteriorly (because Poorly Perfused)
145
What factor stimulates angiogenesis?
FGF
146
What is Fenoldopam?
Hypertensive emergency. D1 agonist. Vasodilation everywhere & natriuresis! (Only drug to decrease BP and increase RBF)
147
How is resistance to INH accomplished?
Decreased expression of catalase-peroxidase enzyme (coded by KatG)
Genetic modification of binding site on mycolic acid synthesis enzyme
148
Nerve with foot drop
Peroneal
149
Describe bone in osteoporosis
Trabecular thinning with fewer interconnections
150
What are the side effects of verapamil
AV block and constipation
151
What do you see on a skin biopsy of eczema contact dermatitis?
Spongiosis
152
What do you use for isolated systolic htn?
thiazide diuretics
or
dihydropyridine Ca antagonists (like AMLODIPINE) **also causes peripheral edema**
153
Match the edema to the htn drug: (2)
ACE- angioedema
| -dipine- peripheral edema
154
What can be used as monotherapy in acute mania? (3)
Lithium
Valproate
Carbamazepine
155
What things can form propionic acid?
Valine, Isoleucine, Threonine, Methionine
odd # FA
cholesterol side chains
156
Major cytokine involved in cachexia
TNF-a
157
Where does Renal Cell carcinoma originate?
PCT
158
Baby with head tilted side ways is caused by
congenital torticollis from *intrauterine malposition*
159
What factor, produced by the vascular endothelium, INHIBITS platelet aggregation?
Prostacyclin (PGI2)
160
Describe stool of people with lactose intolerance (3)
Low pH
increased osmotic gap
Increased H2 breath content
161
What renal structures are damaged in ATN?
PCT!!!!
| also thick ascending limb
162
What cardiac defect is in Downs?
Endocardial cushion --> ostium primum ASD and regurgitant AV valves
163
What kind of receptor is JAK2?
Cytoplasmic tyrosine kinase
164
Why is Buspirone good?
It is a 5HT receptor agonist with **NO sedation, addiction, or tolerance**!!!!
165
Most common cause of acute appendicitis?
Lumen obstruction by fecaliths
166
What do you see in the heart of someone with carcinoid syndrome?
Right-sided valvular disease and intimal thickening
167
What energy source is needed for OAA-->PEP and where does it come from?
GTP; from Succinyl-CoA to Succinate
168
How does Herpesvirus (including CMV...) acquire its membrane?
By budding through the host NUCLEAR membrane.
169
What kidney stones are RADIOLUCENT?
Uric acid
170
What are the only purely ketogenic amino acids (use for tx of PDH deficiency)
Lysine and Leucine
171
What nerve can be damaged in the piriform recess? What reflex does this mediate?
internal laryngeal nerve (branch of superior laryngeal nerve X) --> Carries sensation! Therefore is the afferent limb of the COUGH reflex
172
What drug to use for urinary retention
Bethanechol
173
What type of necrosis is seen after MI?
Coagulative
174
```
Match these markers to their neoplasm:
b-hcg
AFP
CA 125
Carcinoembryonic antigen
CA 19-9
```
b-hcg- choriocarcinoma and some testicular cancer
AFP- hepatocellular cancer, yolk sac tumor
CA 125- ovarian cancer
Carcinoembryonic antigen- solid tissue tumors (for monitoring colorectal, breast, and pancreatic cancer)
CA 19-9- adenocarcinoma of the pancreas
175
Parkinsons patient has gastroparesis... what do you NOT give them?
Metoclopramide
176
I say a. fib, you say look out for
mural thrombi
177
Why is warfarin teratogenic and heparin is not? (pharmacokinetics)
Lipophilic molecules cross the placenta more easily & warfarin = lipophilic.
(Heparin is a charged water soluble material so safer)
178
HIV patient with white opaque patches on the retina has ____? How tx? How does tx work?
CMV retinitis
Ganciclovir
Inhibits DNA elongation both by incorporating into viral DNA and inhibiting viral DNA polymerase
179
What is alcoholic cerebellar degeneration?
Chronic alcoholics can lose Purkinje cells in the anterior lobes and CEREBELLAR vermis. THis causes wide based gait and parkinsonian tremor.
180
Dobutamine
sympathomimetic, b1>b2, a
| ionotropic > chronotropic
181
Phenyephrine
a1 agonst
182
Nodules confined to the septae in cirrhosis are composed of what cells?
Hepatocytes
183
What does the Nernst eq conclude about transmembrane potential?
Potential increases with increases in EXtracellular sodium/ decreases in INtracellular sodium
& vice versa
184
Lactase insufficiency is caused by
Decreased **gene expression**
185
What area of the brain is damaged in Kluver-Bucy syndrome?
Amydgala
186
What causes tardive dyskinesia?
Long term use of antipsychotics can cause *upregulation* of dopamine receptors
187
Acitretin
Systemic psoriasis tx
Synthetic retinoid
Teratogenic!
188
Which rectal vein drains into portal circulation?
Superior rectal --> inferior mesenteric -->portal vein
| Middle rectal vein --> common iliac vein & Inferior rectal vein --> pudendal vein --> both to SYSTEMIC
189
What intestinal parasite has phagositized RBCs?
Entamoeba histolytica
190
Excessive ___ of ____muscle can cause lumbar lordosis.
Flexion of hip
191
Why does serum insulin increase more with PO glucose than IV glucose?
Intestine produces incretins, such as glucagon-like peptide 1 that help increase insulin, independent of blood levels.
192
The skin nodules in NF1 are made of what cell?
Schwann Cell
193
What can a patient take to reduce effects of niacin?
Aspirin (because blocks prostaglandin production that dilates vessels.
194
Describe Ulcerative Colitis morphology
Neutrophils in the crypt abscesses and ulcerations (not through the submucosa)
195
What antidepressant can cause urinary retention and tachycardia?
Amitriptyline (because it has alpha antagonist properties)
196
How does paclitaxel effect stents?
Prevents restenosis due to *intimal hyperplasia*
197
If proline is not hydroxylated in collagen, what happens?
Abnormal triple helix formation
198
Psoas attachments
Lesser trochanter of the femur (in the groin)
&
T12-L4 vertebral bodies
199
Accumulation of microsatellites predisposes to
colorectal carcinoma (HNPCC) because mutations in mismatch repair enzymes can lead to microsatellite instability
200
Renal tumor + lower extremity edema + visible abdominal wall collateral circulation =
Obstruction of the IVC
201
Dermoepidermal junction aggregates of large cells that fuse with adjacent nests
Dysplastic nevus syndrome @ increased risk for melanoma
202
Drug X, when given with GABA, increases Cl- conductivity. This effect is not reversed with Flumazenil.
X= Barbiturates (like phenobarbital)
203
What crosses the diaphragm at
T8
T10
T12
T8- IVC
T10- esophagus + CN10
T12- Aorta + thoracic duct + azygous vein
204
What enzyme traps glucose in b-islets?
Glucokinase
205
What electrolyte can cause nephrogenic DI?
Hypercalcemia
206
Gp2b/3a is what type of receptor?
Integrin
207
Why is it bad to give a kid with Von Gierke's glucose?
Glucose-6-phosphatase is needed in gluconeogenesis to turn fructose into glucose.
208
Start someone on niacin that has HTN and diabetes. How should you adjust meds?
Decrease htn meds
| Increase diabetes meds
209
Pulmonary actinomyces (anaerobic) .... remember what this looks like?
http://www.hindawi.com/journals/crim/2010/282167.fig.002b.jpg
210
Combined UMN and LMN disease of the anterior spinal tracts =
ALS
211
Severe onset chest pain radiating to the back is caused by what mechanism?
intimal tearing
212
What part of hepatitis virus forms spheres and tubules apx 22nm in diameter?
Envelope of HBV
213
How does the body turn pro-carcinogens (like benz-o-pyrene) into carcinogens?
Microsomal monooxygenase (p450)
214
What purine analog, used to treat hairy cell leukemia, is resistant to degradation by adenosine deaminase?
Cladribine
215
The TSST from tampons is caused by interaction of what cells?
Superantigen binds T-cells and macrophages, leading to IL-2, TNF-a, and IL-1 production --> shock
216
How can you tell is B-cell or T-cell ALL?
T-cell has mediastinal compression with possible stridor
217
HCV RNA dep RNA pol lacks ___ activity --> hypervariable
3'-5' exonuclease activity
218
How do you prevent a newborn from getting group B strep?
**Intrapartum** ampicillin or penicillin
| Check mother at 35-37 weeks for GBS
219
Painful bluish lesion under nail is ___ derived from ____ cells.
Glomus tumor from thermoregulatory cells
220
Chronic rejection affects what part of lung allograft?
Small airways (bronchiolitis obliterans)
221
What are the 2 presentations of cryptococcus? You can stain with either India ink or _____ and it looks red!
Meningitis or pulmonary infection
| Mucicarmine
222
How does isoproterenol decrease BP?
Beta-2 receptor stimulation causes vasodilation
223
If aspirate while supine, where does the aspirate go?
Inferior segment of upper lobe
| Superior segment of lower lobe
224
Which sympathetic G-protein receptor increases insulin release? Decreases insulin release?
```
beta-2= INCREASE insulin release
alpha-2= DECREASE insulin release
```
225
How quickly is glycogen depleted? Then what does the body do?
12-18 hours of fasting
| then glycogenolysis
226
Who gets apical subpleural blebs?
Tall thin young males (These predispose to spontaneous pneumothorax)
227
What are pancreatic pseudocysts lined with?
Fibrous and granulation tissue (Note*** that only TRUE cysts are lined with epithelium.
228
What cell provides the proliferative stimuli for atherosclerotic plaques?
Platelets - PDGF
229
What lung diseases cause clubbing?
large-cell carcinoma, TB, CF, **bronchiectasis**, pulm htn, empyema
230
B-symptoms, bilateral hilar adenopathy, and non-caseating granulomas
Sarcoidosis
231
Where is the CTZ trigger zone? (vomit center)
dorsal surface of the medulla near the 4th ventricle
232
Renal complication of sickle cell
Renal papillary necrosis
233
How do you differentiate pilocytic astrocytoma and medulloblastoma?
```
Pilocytic = lateral cerebellum and well-circumscribed
Medulloblastoma = midline cerebellum and aggressive with lots of mitoses
```
234
Which lipid drug can cause gout?
Niacin (can also cause hyperglycemia, hyperuricemia, and hepatitis)
235
What happens to alveoli in ARDS?
Hyaline membranes form
236
Restrictive, fibrosis, cyst formation
Idiopathic pulmonary fibrosis
237
Precursor of NO?
Arginine
238
Rheumatic disease.... what comes FIRST: mitral stenosis or regurgitation?
M. regurgitation 1st
| M. stenosis 2nd
239
Compression of what nerve root causes pain strictly in the posterior thigh and leg shooting to the foot, with decreased plantar flexion and **loss of ankle jerk**
S1
240
Knee jerk reflex nerve levels
L2-4
241
Trigeminal neuralgia initial tx
Carbamazepine
242
Giant cell arteritis patients have _____ disease 50% of the time.
Polymyalgia rheumatica (pelvic and shoulder girdle pain)
243
How treat idiopathic pulmonary arterial hypertension? (What must you monitor on the med?)
Bosentan- a competitive antagonist of the endothelin receptors
*Check LFTs!
244
What senses PaCO2?
| What senses PaO2?
CO2- central chemoreceptors
| O2- Carotid and aortic bodies
245
What medication for gestational diabetes?
insulin
246
Angiomyolipomas are associated with
Tuberous Sclerosis
247
Homeobox codes for
transcription factors/regulators
248
In patients with essential fructosuria, they remain able to use some fructose in glycolysis through the enzyme _____.
Hexokinase
249
What is a P body?
RNA regulation and turnover in the CYTOPLASM
250
How to reduce cisplatin toxicity?
Amifostine
251
Fatigability and weight gain and elevated Creatine Kinase
Hypothyroid myopathy
252
Hibernation vs stunning
Low flow state --> hibernation (reversed by CABG)
| Ischemia induced, reversible, loss of contractility --> Stunning
253
Classic galactosemia inheritance
Autosomal Recessive
254
What hormone signals by increasing cGMP?
ANP
255
Which benzos are short acting?
| Long acting?
```
Short = ATOM
Long= F CDC
```
256
What can halothane do to the liver?
massive hepatic necrosis!
257
What disease has a rash that starts at the head and spreads down AND has posterior auricular lymphadenopathy?
RUBELLA (togavirus)
258
What is a rare but serious consequence of anti-thyroid drugs?
Angranulocytosis
259
Why does left heart failure cause dyspnea?
Decreased pulmonary compliance due to pulmonary edema
260
What does PAS stain?
glycoprotein
261
What can be used to diagnose Prinzmetals? (transient nighttime angina with ST elevations)
Ergonovine
262
Which antipsychotics have more neurologic side effects?
High potency (Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High))
263
Start abx for UTI and 5 days later get a rash and fever with eosinophils
Interstitial nephritis
264
How does Reye syndrome cause coma?
cerebral edema
265
Sigmoid colon metastasizes to what node?
Inferior mesenteric
266
Sildenafil is contraindicated in patients taking
nitrates
267
What is Kussmauls sign?
Rise in JVP with inspiration because the constrictive pericarditis cannot accommodate the increase in volume
268
How to treat serotonin syndrome?
Cyproheptadine (antihistamine with anti-serotonin properties)
269
How does the toxin responsible for the diarrhea in C.diff work?
Toxin B (cytotoxin)- disrupts **actin cytoskeleton** integrity and inactivates regulatory proteins involved in signal transduction
270
What are the causes of metabolic alkalosis? First lab to order to differentiate?
Vomiting
Thiazide use
Hyperaldosteronism
--> Order Cl- because only vomiting will have low Cl-
271
Old man with back pain and large obstructing eosinophilic casts (and no rx history) has
multiple myeloma (Bence Jones protein casts)
272
How does uremia cause bleeding?
Increased bleeding time through platelet dysfunction
| **Normal # of platelets, Normal PT and PTT**
273
What drugs can cause hypothyroidism? (one is an antipsych)
Lithium, amiodarone, sulfonamides
274
What diuretics can cause pulmonary edema
mannitol (the osmotic ones)
275
Antidote to arsenic poisoning
Dimercaprol
276
Which nitrate has the highest bioavailability if given orally?
Isosorbide MONOnitrate
277
FenFen causes death via
pulmonary htn and right sided heart failure that can lead to an arrythmia
278
Mast cells release histamine and
tryptase
279
What bone structural changes occur in primary hyperparathyroidism?
subperiosteal resorption with cystic degeneration
| "brown tumors"
280
What antiviral that can be used for CMV causes hypocalcemia, hypomagnesia, and seizures?
foscarnet
281
Pure RBC aplasia is associated with
THYMOMA, LYMPHOCYTIC LEUKEMIAS, AND PARVO B19
282
What is BRCA?
DNA repair protein (tumor suppressor)
283
Side effect of bupropion in bulimic/anorexic patients?
Seizures
284
Diaphragmatic surface of the heart is supplied by
the posterior descending artery (arises from RCA in most people)
285
Which platelet/coag drug causes thrombocytopenia? Neutropenia?
```
Thrombocytopenia = heparin
Neutropenia = Ticlopidine
```
286
Combination absence and tonic clonic seizure tx
Valpoic acid
287
Most common CV manifestation of SLE
pericarditis
288
Tx of cyanide poisoning?
thiosulfate (sulfer)
or hydroxocobalamin
or nitrite
289
Essential tremor (gets better with EtOH) is tx with
b-blockers
| primidone
290
Massive diarrhea with a lack of gastric acid secretion that is treated with somatostatin is
VIPoma
291
What is a specific finding in graves disease (one you usually forget)
Pretibial myxedema
292
Mechanism of kidney stones in Crohns
Oxalate stones -
Inflamed ileum --> decreased bile acid resorption --> increased fat in stool --> calcium binds fat = soaponification --> oxalate does not bind as much calcium and therefore more oxalate is absorbed --> kidney stones
293
RALES trial showed that the addition of what diuretic improved survival in heart failure patients?
Spironolactone
294
Which lymphoma causes waxing and waning (it is very common)
Follicular (14;18) bcl-2
